2016 INSIGHT Into Diversity Health
Professions HEED Award Application
GENERAL INFORMATION
1. Please provide the complete, formal name of your institution.
2. Check which class applies to your institution. Please select one.
Dental school
Medical school
Nursing school
Osteopathic medical school
Pharmacy school
Veterinary school
Other, please specify: ______________________
3. What is your full-time student enrollment?
0-999
1,000-1,999
2,000-2,999
3,000-4,999
Over 5,000
STUDENT DEMOGRAPHICS
4. What is the breakdown by gender of your full-time student enrollment?
Male
Female
5. What is the breakdown by race/ethnicity of your full-time student
enrollment?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
LEADERSHIP DEMOGRAPHICS
6. What is the breakdown by gender of your administrative leadership (deans,
department chairs/heads, and top hospital administrators)?
Male
Female
7. What is the racial/ethnic composition of your administrative leadership
(deans, department chairs/heads, and top hospital administrators)?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
FACULTY AND STAFF DEMOGRAPHICS
8. What is the breakdown by gender of your associate professor and professor
faculty?
Male
Female
9. What is the breakdown by race/ethnicity of your associate professor and
professor faculty?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
10. What is the breakdown by gender of your instructor and assistant professor
faculty?
Male
Female
11. What is the breakdown by race/ethnicity of your instructor and assistant
professor faculty?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
12. What is the breakdown by gender of your full-time administrative staff (do
not include admissions staff)?
Male
Female
13. What is the breakdown by race/ethnicity of your full-time administrative
staff (do not include admissions staff)?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
14. What is the breakdown by gender of your admissions review committee?
Male
Female
15. What is the breakdown by race/ethnicity of your admissions review
committee?
White/Caucasian
African American/Black
Hispanic/Latino
Native American
Asian American
Native Hawaiian or Pacific Islander
Multiracial
Nonresident alien
16. Does your school have the following? Check all that apply.
Dean of faculty affairs
Professional development funds
STUDENT RECRUITMENT, CURRICULUM, AND RETENTION
17. What efforts do you use to recruit historically underrepresented and firstgeneration students? Check all that apply.
Community outreach efforts
Admissions officers with a diversity focus
On-campus diversity recruitment efforts
Social media outreach
Race-conscious scholarships
Economic-conscious scholarships
Exhibits at national meetings and conferences that focus on underrepresented students
Summer exposure and enrichment programs focused on underrepresented students
Holistic admissions process
18. What efforts do you use to improve retention and graduation rates for
historically underrepresented students? Check all that apply.
Strategic retention plan
Institutional research on student success patterns
Cohort-based academic success and leadership program
Supplemental instruction
Free tutoring support
Culturally relevant advising
Summer bridge programs
Early warning systems
First-year experience programs
19. Please provide the following information regarding your graduates.
What percentage of your graduates have accepted first-year GME
appointments in teaching health centers?
What percentage of your graduates have accepted first-year GME
appointments in underserved communities (nationally and
internationally)?
20. Indicate which of the following topics are included in your curriculum. Check
all that apply.
N/A No Yes Included in ongoing classroom curriculum
Community health
Cultural diversity
LGBTQ health issues
Global health
Health disparities
Interprofessional studies
Minority health issues
Women's health issues
Social determinants of health
Religious beliefs affecting healthcare
Linguistic diversity
Collecting patient demographics
21. Indicate which of the following scholarship/grant/loan opportunities your
institution provides for students. Check all that apply.
Scholarships for disadvantaged students
National Health Service Corps
Armed forces health professions scholarships
Indian Health Service
AmeriCorps
Loans for disadvantaged students
Outside-funded need-based scholarships without a service commitment
Institution-funded need-based scholarships without a service commitment
Tell us about any other programs not listed above.
22. Tell us about any pipeline programs your school has with other institutions.
Include the names of those institutions.
23. Indicate the extent to which your institution has made progress in the
following areas.
Strongly Agree Agree Undecided Disagree Strongly Disagree
Health promotion
Preventive care
Linguistic competence
Cultural competence
FACULTY RECRUITMENT AND RETENTION
24. What strategies does your school have in place to increase the ethnic, racial,
and gender diversity of your instructional faculty on campus? Check all that
apply.
Faculty diversity strategic plan
Dedicated faculty diversity recruitment specialist
National partnership efforts
Advertisements in diversity-only publications and/or job boards
Participation in diversity recruitment events
Strategic funds to increase financial offers to diverse job candidates
Grant-funded initiatives to increase retention (e.g., NSF Advance program)
Strategic funds to hire diverse candidates
Hosting future faculty diversity symposiums on campus
Please list diversity publications and job boards you use. (Do not include The
Chronicle of Higher Education, Inside Higher Ed, or Higher Ed Jobs, as these are
not diversity job boards.)
25. What strategies does your school use to retain ethnically, racially, and
gender-diverse faculty on your campus? Check all that apply.
Mentor programs for diverse junior faculty
Cohort-driven leadership programs for diverse junior faculty
Graduate research support for new diverse faculty
Start-up research funds for new diverse faculty
Family-flexible tenure time lines
Affinity or employee resource groups for employees
LEADERSHIP AND ACCOUNTABILITY
26. Indicate the role the dean plays in your school's diversity policies.
Strongly
Agree
Agree Undecided Disagree Strongly
Disagree
Establishes the vision for diversity
Charges the diversity committee
Creates a culture of accountability
Ensures that resources (funding and
staff) are available to drive campus
diversity efforts
Shows a visible commitment to diversity
in speeches, written correspondence,
and public appearances
Ensures that senior leadership is
engaged in school's diversity agenda
Provide further commentary on the dean's role in ensuring the placement and
execution of your school's diversity efforts. Include any additional efforts not
listed above, explain any existing weaknesses, and include any suggestions for
improvement.
27. What strategies does your school have in place around diversity planning
and accountability? Check all that apply.
Our school's official mission statement includes diversity and inclusion language.
Our diversity and inclusion goals and plans are embedded in our strategic plan.
Our school has a diversity planning committee or taskforce.
Our school uses a diversity scorecard process to measure our diversity progress.
Our diversity office has the opportunity to formally report on campus diversity plans,
successes, challenges, and opportunities at meetings of the board of governors, trustees, or
regents.
28. Does your school have diversity training programs for the following groups?
Voluntar
y
Require
d
Upon
Hirin
g
Start of
Academi
c Year
Annuall
y
Ever
y
Two
Year
s
No
Diversit
y
Trainin
g
Unconsciou
s Bias
Training
Senior
administrator
s
Full-time
faculty
Full-time
staff
Search
committee
heads
Board of
trustees or
regents
Full-time
students
29. Please indicate the degree to which you agree or disagree with the following
statements regarding activation of your diversity plan.
Strongly
Agree
Our dean is highly involved in
diversity implementation efforts.
Our chief diversity officer provides
point leadership in the diversity
implementation process.
Our diversity committee ensures
that many different people are
involved in shaping the school's
diversity strategy.
Students play a key role in leading
diversity change efforts on our
Agree Undecided Disagree Strongly
Disagree
N/A
campus.
Diversity efforts are data-driven
and evidence-based.
Adequate financial resources exist
to drive diversity efforts.
Participation in diversity-related
programs is considered in the
tenure and promotion process.
Add any additional comments about the diversity plan activation process for
your school.
30. Identify any diversity-focused financial strategies that exist at your school.
Check all that apply.
Diversity goals are embedded into the overall budget process.
We have an annual diversity fundraising program.
We have diversity incentive grants (e.g., pool of funds for which anyone can compete).
We apply for federal diversity grants (e.g., NSF, NIH, U.S. Department of Education).
We have a dedicated development officer focused on diversity.
We have a qualified diversity endowment.
We have a diversity-themed alumni fundraising program.
Other: ______________________
BRANDING
31. Identify any multicultural branding and communication techniques your
school uses. Check all that apply.
Social media used for multicultural marketing (e.g., YouTube, Instagram, Twitter, Facebook,
etc.)
Multicultural communications officer or specialist
Diversity-themed admissions materials and brochures
Diversity advertising and outreach campaigns (e.g., display/image advertising in diversity
publications like INSIGHT Into Diversity magazine, billboards, commercials)
Annual diversity report
Student ambassadors communicate campus diversity to prospective students and their parents
Display all diversity awards received on website
Diversity link on website homepage
List any other diversity branding techniques your school uses that are not listed
above.
32. Please identify which of the following diversity-related information appears
on your website. Check all that apply.
Our procurement office/supplier diversity page lists opportunities for minority- and womenowned businesses.
Our study abroad page includes specific opportunities for underrepresented students (e.g.,
scholarships).
Our disability services office page links to the career services page.
Our international office page includes information about student groups that students can join.
Our human resources page includes information about affinity groups employees can join.
Our human resources page includes information about diversity training.
Every job listing on our human resources page includes an AA/EEO statement.
CHIEF DIVERSITY OFFICER'S ROLE (OR SIMILAR TITLE)
33. Please identify which, if any, of the following tactics your school uses to
understand issues of campus climate, inclusion, and satisfaction. Check all that
apply.
Climate survey for faculty — How often is this conducted? ______________________
Climate survey for students — How often is this conducted? ______________________
Climate survey for administrative staff — How often is this conducted? ______________________
Satisfaction survey for students — How often is this conducted? ______________________
Satisfaction survey for employees — How often is this conducted? ______________________
Diversity mapping of school's capabilities
Diversity benchmarking efforts
Exit interviews for students
Exit interviews for employees
34. How is your chief diversity officer's role situated for success? Check all that
apply.
We don't have a dedicated chief diversity officer.
Our chief diversity officer reports to the dean.
Our chief diversity officer position is an executive-level role.
Our chief diversity officer has a dedicated staff — How many? ______________________
Our chief diversity officer has other titles (e.g., Title IX coordinator, EEO officer) — Please list:
______________________
Our chief diversity officer has his/her own budget
Our chief diversity officer has a deciding vote on the diversity council.
Our chief diversity officer can attend board of trustee meetings to present the case for diversity.
Our chief diversity officer has input in the budget for his/her office.
35. Identify the employee resource or affinity groups you have at your school.
Check all that apply.
African American/Black affinity group
Hispanic/Latino affinity group
Asian American/Pacific Islander affinity group
LGBTQ affinity group
Disability affinity group
Religious-affiliated affinity groups
Veteran's affinity group
Women's affinity group
Native American affinity group
36. Does your school have or offer the following (currently or in the near
future)? Check all that apply.
Gender-neutral bathrooms
Same-sex partner healthcare benefits for employees
DIVERSITY PROGRESS
37. We would like to know the degree to which you have successfully increased
minority and female representation at your school. Using the most recent
information from your annual diversity report or campus climate survey,
identify statements that apply to your school.
Less
than
1%
We have increased the number of
underrepresented minorities in full-time
professor positions over the past five years.
We have increased the number of women in
full-time professor positions over the past five
years.
We have increased the number of
underrepresented minorities in top
administrative leadership positions over the
past five years.
We have increased the number of women in
top leadership positions over the past five
years.
We have increased the number of full-time
underrepresented minority students over the
past five years.
13%
46%
710%
1115%
Over
16%
N/A
MISCELLANEOUS QUESTIONS
38. Please tell us how you first heard about the INSIGHT Into Diversity HEED
Award?
Past award recipient or applicant
Colleague
Search engine
Conference
INSIGHT Into Diversity newsletter
INSIGHT Into Diversity magazine
Other: ______________________
39. Why did you apply for the Health Professions HEED Award?
40. Do you have any feedback you would like to submit regarding the Health
Professions HEED Award or this application?
OTHER APPLICATION INFORMATION
The deadline to submit your Health
Professions HEED Award application is July 15, 2016. If your school is selected as
an INSIGHT Into Diversity Health Professions HEED Award recipient, you will be
notified by Sept. 15, 2016. Each HEED Award recipient will receive a 2016 Health
Professions HEED Award certificate and the 2016 Health Professions HEED
Award logo. All Health Professions HEED Award recipients will be officially
announced and featured in the December 2016 issue of INSIGHT Into Diversity
magazine. If you would like to submit additional information to accompany this
application, please email it to heedawardapplication@insightintodiversity.com
by the application deadline. Please make sure you print a copy of your
completed application for your records. Thank you for applying for the 2016
INSIGHT Into Diversity Health Professions HEED Award!
You hereby certify as a representative of your school that the information
submitted in this application is accurate and correct to the best of your ability.
Your name
Your title
Your phone number
Your email address
CONTACT INFORMATION
Please provide contact information for your chief diversity officer or dean (or
the person we should contact if your school is selected as a Health Professions
HEED Award recipient).
Name (include credentials — e.g., PhD, JD)
Title
Mailing address 1 (No P.O. boxes, please)
Mailing address 2
City
State
Zip code
Phone number
Email address
Please provide contact information for your director of marketing.
Name
Title
Phone number
Email address
Please provide contact information for your director of public relations (if
different from above).
Name
Title
Phone number
Email address